Document Type
Article
Publication Title
Prenatal diagnosis
Abstract
OBJECTIVE: To evaluate the impact of amnioinfusion and other peri-operative factors on pregnancy outcomes in the setting of Twin-twin transfusion syndrome (TTTS) treated via fetoscopic laser photocoagulation (FLP).
METHODS: Retrospective study of TTTS treated via FLP from 2010 to 2019. Pregnancies were grouped by amnioinfusion volume during FLP (< 1 L vs. ≥1 L). The primary outcome was latency from surgery to delivery. An amnioinfusion statistic (AIstat) was created for each surgery based on the volume of fluid infused and removed and the preoperative deepest vertical pocket. Regression analysis was planned to assess the association of AIstat with latency.
RESULTS: Patients with amnioinfusion of ≥1 L at the time of FLP had decreased latency from surgery to delivery (61 ± 29.4 vs. 73 ± 28.8 days with amnioinfusion < 1 L, p < 0.001) and increased preterm prelabor rupture of membranes (PPROM) < 34 weeks (44.7% vs. 33.5%, p = 0.042). Amnioinfusion ≥1 L was associated with an increased risk of delivery < 32 weeks (aRR 2.6, 95% CI 1.5-4.5), 30 weeks (aRR 2.4, 95% CI 1.5-3.8), and 28 weeks (aRR 1.9, 95% CI 1.1-2.3). Cox-proportional regression revealed that AIstat was inversely associated with latency (HR 1.1, 95% CI 1.1-1.2).
CONCLUSION: Amnioinfusion ≥1 L during FLP was associated with decreased latency after surgery and increased PPROM < 34 weeks.
First Page
1239
Last Page
1246
DOI
10.1002/pd.6415
Publication Date
8-1-2023
Recommended Citation
Forde B, Lim FY, McKinney DN, Habli M, Markham KB, Hoffman M, Tabbah S, Oria M, Peiro JL. Association of amnioinfusion volume at the time of surgery for twin-twin transfusion syndrome and latency to delivery. Prenat Diagn. 2023 Aug;43(9):1239-1246. doi: 10.1002/pd.6415. Epub 2023 Aug 8. PMID: 37553727.